| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medcost
| Facility | $450.53 | $535.62 | $1,203.29 | |
Oscar Health
| Professional | $505.30 | $505.30 | $505.30 | |
Wellcare
| Facility | $55.00 | $866.28 | $13,311.95 | |
Wellcare
| Professional | $1,829.86 | $2,580.30 | $2,580.30 |